How to screen for cervical cancer?

  According to the World Health Organization (WHO), 450,000 new cases of cervical cancer occur each year worldwide, of which 135,000 new cases occur each year in China, accounting for about one-third of the world. In recent years, the incidence of cervical cancer has increased significantly and tends to be younger due to the increase of human papillomavirus (HPV) infection. Recent studies have shown that cervical cancer has a long and reversible precancerous period, and after early detection and timely treatment, the five-year cure rate of cervical cancer patients has reached 90%, which shows that cervical cancer is a preventable and curable disease. Therefore, the screening and prevention of cervical cancer is of great significance.  1. The traditional manual method (Pap smear) was invented by Papanicolaou (Pap), a Greek physician, and started to be used for cervical cancer screening in the 1940s. Because of its simple method, painless to patients and low cost, it is very suitable for screening a large population and has been used for nearly half a century and is still used in some places.  Method: A cork scraper is used by an obstetrician and gynecologist to gently scrape and collect exfoliated cells from the cervix, smear them on a slide, and then make a diagnosis by a pathologist under a microscope after staining. Disadvantage: the false negative rate is high, i.e. the misdiagnosis rate.  2.CCT-computer-assisted reading system American developed a system called “brain neural network simulation system” for scanning traditional Pap smear, i.e. CCT examination. After 2000, the CCT has been replaced by a new generation of automated cytology scanning systems.  3, TCT-membrane liquid-based thin-layer cytology test one of the main reasons for missed or misdiagnosed traditional Pap smears is that cells are lost during sampling and poor smear quality, and in the 1990s there was the emergence of the new Pap membrane liquid-based thin-layer cytology technique (TCT).  Method: The physician delivers the collected cells to the laboratory in a specimen bottle containing cell preservation solution, and the production process is controlled by a computer program. The main steps are, cell mixing; cell negative pressure collection; and cell transfer. The advantage is that impurities are removed and a clear monolayer smear of cells is formed, which can be seen by the pathologist at a glance, leading to a significant increase in the diagnosis of cervical cancer, especially precancerous lesions.  In addition, the preserved fluid of TCT can be directly used for human papillomavirus gene detection.  4.Virological testing: human papillomavirus (HPV) gene high-risk type detection Current information proves that HPV infection is the most important cause of cervical cancer and its precancerous lesions, and HPV virus can be found in 99.8% of cervical cancer patients. The latest methods approved for clinical use to detect HPV infection include hybridization capture method.  Method: Cells are collected at the cervix with a special small brush, without injury or pain to the patient. The accuracy of this method is quite high, but it is usually used only in high-risk groups because of its high cost.  5. Colposcopy When abnormalities are found in the cervical cytology smear, colposcopy is done to identify the lesion and, if necessary, several pieces of tissue are taken and sent for pathological examination to provide a basis for surgical treatment.  6. Human papillomavirus (HPV) vaccine: Since the main causative factor of cervical cancer is HPV infection, the fundamental method is to use vaccine prevention, including preventive vaccine and therapeutic vaccine. In the near future, cervical cancer will become a malignant tumor that can be fully prevented and eradicated by human through immunization methods.